Although the incidence of breast cancer is lower in African Americans, the risk of dying is twice as great for African Americans than Caucasians. The Black/White Cancer Survival Study of the NCI concluded that 75% of the racial differences in survival from breast cancer was explained by the fact that more African Americans were diagnosed with advanced disease. In 2002 a study of US population-based registries reported that both Hispanic and African American women had higher odds ratios for larger tumors at diagnosis, even after adjustment for all other study variables. Although the use of mammography has increased over time, the majority of breast cancers are still first discovered by the patient as a palpable lump. Nevertheless, women commonly delay in seeking medical care for 3 or more months after self-discovery of a breast symptom, and cultural factors appear to play an important role. The purpose of this study is to identify factors that contribute to delay in seeking medical care for breast cancer for African American, Hispanic and white women in Chicago. This study seeks to identify variables contributing to later stage of breast cancer at medical presentation, focusing primarily on women in middle and lower income groups. The information provided by this study will be used to tailor interventions to decrease delay in these groups, which will be pilot tested in the final years of this project. Aim 1. To identify the cultural beliefs about breast cancer contributing to delay in Black, Hispanic, and Caucasian women in Chicago (n = 75), and to examine the influence of cultural orientation on delay. Aim 2. To develop versions of an instrument to assess cultural beliefs contributing delay for Black, Hispanic, and Caucasian women (n = 150), and to validate the measure of cultural orientation and other instruments to be used in this study. Aim 3. To examine the relationship between the perceived threat of breast symptoms and the time to first contact with health care providers and identify the individual, social, and economic factors contributing to delay in African American, Hispanic, and white women in Chicago (n = 450). Women from the three ethnic groups, who are similar in terms of age and socioeconomic status, will be compared to identify similarities and differences among the groups in the factors that contribute to delay. Aim 4. To develop and pilot test interventions to decrease delay in the three ethnic groups, in collaboration with community partners.